HRSA/HAB News

New Guide: Hepatitis C Treatment Models and Steps for Creating Them

Hepatitis C can be cured using more effective and tolerable hepatitis C treatments and yet hepatitis C remains a leading cause of morbidity and mortality among PLWH. HRSA/HAB released a new technical publication in June outlining five models that Ryan White clinics can follow in putting HCV treatment in place for their coinfected patients. The guide, Integrating Hepatitis C Treatment In Ryan White Clinics: Models & Steps, also outlines nine steps that Ryan White agencies can undertake in deciding how to integrate HCV treatment within their HIV/AIDS primary care services. These models and steps reflect insights from Ryan White clinics on ways to tackle HCV management and treatment—from setting up referral systems with external HCV services to incorporating HCV care and treatment within their own walls.

The guide states, “All Ryan White-funded clinics should be monitoring HCV disease among their coinfected patients and evaluating them for potential HCV treatment. Ryan White agencies should also take the next step and help fill gaps in HCV treatment services not being adequately addressed by HCV specialty clinics.” View the guide. (PDF – 513KB)

New HRSA CAREAction: Medication-Assisted Addiction Treatment

Addressing co-occurring conditions such as HIV and substance use demands a comprehensive, holistic approach, which has become one of the hallmarks of the Ryan White HIV/AIDS Program. The latest issue of HRSA CAREAction focuses on medication-assisted therapies (MAT) for addiction. The use of methadone and buprenorphine for opioid dependence is discussed. Also discussed is the use of MAT in the treatment of alcohol dependence. The newsletter has an extensive listing of resources for providers. View this issue.

TARGET Feature: Hepatitis C, HIV, and Ryan White Providers

Anywhere from 25-35 percent of the 1.1 million Americans infected with HIV/AIDS are coinfected with hepatitis C virus (HCV). Infection rates are much higher among certain subpopulations of HIV-infected individuals, such as injection drug users. Liver disease that is tied to HCV infection is a leading cause of death among HIV-infected individuals.

Data systems are expanding and linking agencies in an effort to create a national electronic medical records system that can help agencies deliver better care and report on the services they provide. One of the many tasks required to operate integrated systems is to secure "business agreements" among agencies, which outline requirements regarding data sharing, confidentiality, and HIPAA regulations. Ryan White agencies shared sample business agreements on the CAREWare listserv, and they have been compiled into a portfolio in the TARGET Center.

Mecklenburg County's agreement includes specific provisions that address data confidentiality as outlined under the Federal HITECH Act. Louisiana's CAREWare network uses an affiliation agreement instead of a business agreement, following the advice of their State legal department. Forms from the Hartford Part A EMA cover CAREWare data confidentiality. To see the portfolio of business/affiliation agreements, look under “What’s New” at the TARGET Center.Also see the Data Academy multimedia trainings,which include modules on HIPAA and data sharing and other related topics.

HAB Website: Updated Living History

The Living History section of the HAB Website has been updated to reflect 2010 activities, most notably, the 2010 timeline, which celebrates 20 years of leadership, and the Legacy of Care video that was shown at the 2010 All Grantee Meeting. View the Living History.

Webinar on Women and HIV: June 22

The TX/OK AIDS Education and Training Center (AETC) is holding a Webinar series, “Women and HIV: Clinical Concepts from the Women and HIV International Clinical Conference (WHICC),” which will start on June 22, 8:30 am CT with a day-long Webinar. This free Webinar series features experts in the field of treating women with HIV. Clinicians participating will gain competencies in decreasing barriers for HIV testing, linkage to care, and retention in care for HIV-infected minority women. Pre-registration is required and registration for the first Webinar closes June 20. Learn more. Learn more about clinical care TA.

SPNS Findings from IT Networks of Care

HRSA/HAB’s SPNS Program funded a 4-year initiative to support organizations that promote the enhancement and evaluation of health information electronic network systems for PLWH in underserved communities. Factors associated with effective and quality health delivery systems include coordination, comprehensiveness, integration, and cultural competence. However, HIV service delivery systems are often fragmented and lack coordination across a city or rural region, making it difficult for PLWH to benefit from the multidisciplinary approach to care on which quality HIV/AIDS clinical management is based.

The final grantee meeting takes place on June 17 and will feature data findings and policy implications, as well as strategies for implementing successful models of care and sustainability beyond Federal funding. Demonstrations sites will present findings and lessons learned. Learn more about this SPNS initiative.

New Initiative Focuses on Integrating HIV Services into Primary Care

The AIDS Education and Training Centers (AETC) National Center for HIV Care in Minority Communities (NCHCMC) has launched a new initiative to integrate HIV services into community health centers. Twenty-four (24) health centers will participate in this 3-year effort to expand primary care services in health centers in order to better serve communities disproportionately impacted by HIV. Funded by HRSA/HAB through the Minority AIDS Initiative and the AETC program, the AETC NCHCMC is led by HealthHIV in collaboration with the National Association of Community Health Centers.

The health centers selected for the program deliver primary care services to more than 375,000 patients a year, including 1,769 individuals diagnosed as HIV positive. Sites will participate in an innovative curriculum, rooted in the Patient Centered Medical Home model of care, with HIV as the population of focus. Learn more. (PDF – 117KB)

Other News

Affordable Care Act: Medicaid Coverage Opportunities for PLWH

The Centers for Medicare and Medicaid Services (CMS) has released a State Medicaid Director letter providing guidance to inform States of opportunities to provide Medicaid coverage to individuals living with HIV in support of President Obama’s National HIV/AIDS Strategy.

This guidance informs States on how to apply for opportunities in the Medicaid program that allow for flexibility to improve care and care coordination and offer options to treat individuals living with HIV in the community. States may choose to apply for one or more options to extend coverage to individuals living with HIV: Community First Choice; Health Home for Enrollees with Chronic Conditions; Section 1915(c) Home and Community Based Services Waiver; Section 1915(i) State Plan option; Money Follows the Person Rebalancing Demonstration; and Section 1115 Demonstrations. These coverage and service design opportunities may assist States in increasing access to care for individuals living with HIV, provide alternatives that could alleviate the current burden to AIDS Drug Assistance Programs (ADAP), and help States make progress towards expanding coverage and providing access in accordance with the Affordable Care Act requirements. For more information.

MMWR: 30 Years of HIV/AIDS

The June 3 (Vol. 60, No. 21) issue of MMWR includes three articles related to the observance of 30 years of the HIV epidemic.

Thirty Years of HIV – 1981-2011

HIV Surveillance – United States, 1981-2008

HIV Testing Among Men Who Have Sex with Men – 21 Cities, United States, 2008

A proposed privacy rule by the Department of Health and Human Services (HHS) would give patients a chance to see a detailed report of who has accessed and viewed their electronic health records (EHRs). Under current Health Insurance Portability and Accountability Act (HIPAA) rules, physicians, hospitals, health plans, and other health care organizations are required to track access to electronically protected health information. However, they currently are not required to share this information with patients.

If the proposed rule is approved, providers will be required to inform patients that they can request the detailed privacy report beginning Jan. 1, 2013, assuming the rule takes effect. The proposed privacy rule is divided into two separate rights for patients. The right to an access report includes information on who has accessed the electronic protected health information and for what purpose (such as treatment, payment, and health care operations). The right to an "accounting of disclosures" would provide additional information about whether the data was obtained through hard copy or electronically, and whether it was used for purposes, such as law enforcement, judicial proceedings, and public health investigations.

The proposed changes are in response to the HITECH Act, which called for a more complete accounting of disclosures of protected health care data than currently provided by HIPAA as providers and hospitals work to digitize health records and exchange patient data. HHS will take comments on the proposed rule until August 1. View the proposed rule. Submit comments.

mental healthAIDS: HIV Prevention Advances

The most recent issue of mental health AIDS focuses on HIV prevention. In this issue, recent advances in biomedical HIV prevention research are contrasted with the poor showing of behavior-change interventions that included a reduction in the sexual transmission/acquisition of HIV as an outcome. Also is included a description of a mental health-focused HIV prevention model developed in Chicago that picks up on several trends, such as positive prevention, task-shifting, and a computer-driven protocol, by employing and training HIV-positive peer advocates to administer an individually tailored counseling intervention for sexual safety and general coping in the HIV primary care setting. View this issue.

In addition to the resources listed above, don’t forget to check out these other HAB resources, which are updated regularly.